February 2010

February 2010, Vol. 20, No. 1
Cystic Fibrosis on the Trail
A newsletter from the CF Association of Missouri, a group dedicated to
the persons and families confronted with cystic fibrosis who share common
interest in the care and management of cystic fibrosis. This publication
provides information, views, and news about cystic fibrosis to all the
families, and friends of CF in our area.
2684 County Rd. 4028 • Holts Summit, MO 65043 • (573)896-4737
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“Cystic Fibrosis on the Trail” is a publication of the Cystic Fibrosis Association of Missouri (CFAM) and your University
of Missouri Cystic Fibrosis Center in Columbia.
The Editorial Staff: Tony North, Editor; Christina Korth, Assistant Editor; Deborah Chance, PhD, Assistant Editor; Diane Carney,
CFAM Treasurer; Laura Frasher; Lois Frazier; Sally Hicks; Connie Fenton, RN, BSN; Peter König, MD, PhD, CF Center Director.
Table of Contents
Table of Contents............................................................................................................................................................................... 2
Division News.................................................................................................................................................................................... 3
Doc’s Corner...................................................................................................................................................................................... 4
Nutrition Nitch................................................................................................................................................................................... 4
Kecia’s Korner................................................................................................................................................................................... 6
Research Updates............................................................................................................................................................................... 7
Sharing Spot..................................................................................................................................................................................... 10
Sharing Spot includes various entries from folks in our CF community.
CF Events 2009................................................................................................................................................................................ 11
Upcoming CF Events....................................................................................................................................................................... 20
Calendar of Events........................................................................................................................................................................... 22
How to Contact Us........................................................................................................................................................................... 23
Cover Photo: Stylized Photograph of avid horseman Jamey May (of the original Jamey’s Trail Ride back in the 1980’s) on his
horse Cody.
University of Missouri CF Center
During working hours: please call the Child Health/CF Office at (573) 882-6978.
For emergencies after hours:
please call the University Hospital operator, (573) 882-4141, and ask to have the
“cystic fibrosis doctor on call” paged.
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Division News
From the Director
Child Life Specialist
As you probably know Dr. Guajardo moved to Texas in
November, therefore our Center is even more shorthanded
with doctors.
Fortunately, we succeeded in recruiting a new Division
Chief and CF Center Director. Dr. James Acton is at present
the CF Center Director at the Cincinnati Children’s Hospital.
He will join us in July 2010 and become the CF Center
Director.
I will at that time step down as Center Director and
Pulmonary Division Chief, but continue my CF and
Pulmonary outpatient clinics. I will then no longer do
inpatient care.
We are still trying to recruit another Pulmonologist and
will replace Dr. Guajardo with an allergist.
Peter König, MD, PhD
Hello everyone! My name is Emily and I am the new
Child Life Specialist on the Pediatric floor at University
Hospital. I am so excited to be apart of the Children’s
Hospital team! It’s my job to help make the hospital a fun
and relaxing environment for the children, as well as, provide
encouragement and support in stressful situations. Here’s just
a little bit about me: I’m from St. Louis, but am enjoying life
in Columbia. My husband and I will be adding to our family
in February! When I have some extra time, I love watching
Cardinals baseball and taking my 80 pound puppy for walks.
Springfield Clinic
We need your help to have Springfield Clinic run
smoothly. We are asking that you follow the guidelines
below regarding your Springfield Clinic appointment. We
will be mailing out reminders two weeks before your clinic
appointment.
Guidelines:
1. Please arrive on time for your appointment.
2. If you are more than 1 hour late for your appointment,
you will need to reschedule for the next month’s clinic.
3. If you arrive prior to your scheduled appointment you
may have to wait until your scheduled time depending on
how the clinic is moving.
4. Please call our office at 573-882-6978 by the Monday
before your clinic appointment to cancel if you are not
going to be able to keep you appointment. This will allow
us to make any changes necessary to our schedule.
5. Please call the office to schedule an appointment if you
think that you need to be seen; surprise appointments only
make the other scheduled patients wait to be seen.
By everyone following these guidelines, we will be
able to see everyone on time. We strive to make your clinic
visit as efficient as possible. Thank you in advance for your
cooperation.
University of Missouri Health Care
Visiting Guidelines
• Regular visiting hours at University and Children’s
Hospital are between 9 a.m. to 9 p.m. seven days a week.
• Children younger than 13 must be accompanied at all
times by an adult other than a hospital patient.
• To ensure the safety of our patients and visitors all of
the doors lock after regular visiting hours. We have
implemented additional visiting rules from 9 p.m. to 9
a.m. All overnight visitors must check in with security or
a hospitality coordinator by 9 p.m. for an identification
badge to show visitors are approved overnight guests.
• Overnight visitors must be 18 years old or older.
• Waiting areas on inpatient floors are designated “quiet
areas” from 10:30 p.m. to 8 a.m. Television must be
turned off during that time. Visitors may watch TV during
quiet hours in the hospital’s main lobby.
• Please see the Visiting Guidelines sheet located in visiting
waiting areas for more guidelines and information.
Congratulations Dorothy Martin, LPN on your
35 years of dedication to Children’s Hospital!
We appreciate everything you do.
A new home for TJ is coming soon!
Children’s Hospital will be moving this fall to
our new location at Columbia Regional Hospital.
CRH is conveniently located at the intersection
of Hwy 63 & I-70. We’ll let you know when we get
moved and are ready to show off our new home!
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Doc’s Corner
Exercise Study
available clearly supports the beneficial effects of short-term
exercise during hospitalization, and we believe that long term
exercise programs will have powerful benefits too, both, in
pulmonary function and airway clearance. More studies are
needed to fully support this approach.
Jesus Ramon Guajardo, MD, MHPE
(contributed before his move to serve
the good folks of Texas)
We all know that having a balanced life is important and
that’s the reason we strive to have good habits, including
hygiene, nutrition, sleep, and exercise. Well, just this year
the Disability and Rehabilitation journal published a review
by Nancy van Doorn focusing on exercise programs for
cystic fibrosis (CF). Nancy van Doorn found four studies
that were rigorous enough to be further discussed and
one of those studies pointed out that there was significant
improvement in pulmonary function from short-term
exercise interventions during hospital admissions for patients
with CF. The original study was conducted by Selvadurai
(Pediatr Pulmonol 2002) and in that study patients utilized
the treadmill (for 30 minutes) and also did weights (5 sets
of 10 reps) five times per week during their hospitalization
stay. It was interesting, but not surprising, that the patients
that exercised did much better than the ones that did not.
On average the forced expiratory volume in the first second
(FEV1) improved by about 6.5% for the treadmill group
and by 10% for the weights group. These numbers are
remarkable if we think that many of our patients use chronic
therapies, such as hypertonic saline and azithromycin, to
get 5 to 10% improvement on their FEV1. In addition, the
increase of FEV1 with exercise may look very attractive to
hospitalized patients because it may signal an improvement
in lung function with positive repercussions towards an early
discharge and the overall quality of life.
In summary, more studies are needed to actually prove
without doubt that exercise improves FEV1 in patients with
CF, but in view of its beneficial effects I think we should
advocate for it every admission. Of consideration is that the
level of exercise mentioned on the study by Selvadurai was
not achieved by just having the patients ‘stroll around the
halls’ or having them leisurely walk on the treadmill; patients
were asked to perform at 70% of the maximum. So keep
this in mind next time your health care provider asks you or
your family member to exercise more. So far the evidence
CF Newborn Screening: Early Detection
and Prompt Intervention
Since June 2007, Missouri has implemented newborn
screening for cystic fibrosis. When babies are born, blood is
collected by heel stick to screen for CF and other congenital
disorders. These samples are sent to the Missouri State
Laboratory and an IRT (immunoreactive trypsinogen) level
is measured. Elevated IRT levels are abnormal, so definitive
testing by sweat chloride measurement is required.
Through this method, more than 49 babies have been
diagnosed with cystic fibrosis in Missouri. Majority of
these babies have difficulty gaining weight and some have
respiratory symptoms like cough and wheezing. When
they are followed at the four CF Centers in the state:
University of Missouri, St. Louis Children’s Hospital,
Cardinal Glennon and Children’s Mercy Hospital, they are
thoroughly evaluated and appropriate therapies are started.
Interventions include frequent visits, regular weight and
length measurements, enzyme and vitamin supplementation,
addition of extra salt and calories, and chest physiotherapy.
Although quite overwhelming for a family with a new
baby, these interventions are intended to boost nutrition and
delay onset of lung disease. For most babies, these treatments
focus on CF disease even before obvious symptoms are
present. It is like having an umbrella ready when you know it
is going to rain!
Zarah Ner, MD
Nutrition Nitch
Healthy High Calorie Diets
Eating a high calorie high fat diet can be difficult
especially since our society emphasizes healthy eating.
Eating enough calories to gain or maintain weight can be
very difficult for people with CF. Knowing that nutrition and
lung health go hand in hand our CF center has been trying to
improve the nutrition status of our patients.
Many people have questioned how can a high calorie
high fat diet be healthy. Here are some ideas that fit into the
CF diet but also promote healthy eating.
Cereals can be high calorie and contain many essential
vitamins and minerals. Cereals are also high in carbohydrates
which provide fuel for you body. Adding ½ cup whole milk
to 1 cup of a high calorie cold cereal can provide at least
275 calories per serving. Some high calorie cereals include
Frosted Mini Wheats, Raisin Bran, Honey Nut Clusters,
Cracklin’ Oat Bran, Banana Nut Crunch. Hot cereals also
fit into a healthy high calorie diet. One packet of flavored
instant oatmeal with ½ cup heavy cream can combine to
provide 575 calories.
Many milk and dairy products are high in calories but
also supply your body with protein and calcium. Protein
is essential for building muscle in your body and calcium
builds strong bones. Custard yogurts can provide 190
calories per serving. Higher calorie milk can be made
with whole milk and instant nonfat milk. Combine 1 quart
whole milk with 1 cup instant nonfat milk to make 4- 1
cup servings that provide 210 calories per serving. Choose
cheeses that are made with whole milk over those made with
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low fat milk. Instant pudding can be made with heavy cream
instead of using milk; ½ cup will provide 300 calories.
Nuts and peanut butter are great sources of protein. Trail
mixes can be made at home by mixing nuts, seeds, dried
fruit, pretzels and chocolate chips. Or you can choose from
several varieties of trail mix from the grocery store. Peanut
butter can be added to many foods like crackers, apples and
celery for great snacks. Sunflower seeds or mixed nuts also
make great healthy snacks; ½ cup sunflower seeds provide
375 calories.
There are a variety of snack bars on the supermarket
shelves today. Some provide more calories than others. When
selecting from different brands it is important to look at the
food label and choose the highest calorie bar.
Eating a high calorie high fat diet can be healthy. Please
talk with me in clinic if you need other ideas on ways to
increase your caloric intake.
Christina Korth RD, LD
Eating Strategies to
Gain Weight
• Eat frequently! Make time for 3 large
meals and 2-3 hefty snacks every day
• Eat larger portions, especially foods that
are higher in calories: starchy vegetables,
breads, pastas, rice, nuts, cheese, dried
fruit, beans
• Add lots of “extras” to food! Don’t eat
anything plain. Some ideas:
Healthy Fats: Olive and canola oil,
nuts, seeds, peanut butter, avocado,
DHA enriched margarines, butter
Healthy carbs and protein: Honey,
jam, dried fruit, wheat germ, dark
chocolate, syrup, cheese/dairy
• Make beverages count! Drink shakes,
whole milk, juices, smoothies (instead of
water, coffee, tea and diet sodas)
• Use large plates/bowls and utensils, such
as spoons and forks, when you are eating at
home
• Snack while watching TV or working on
the computer, especially if it is at least a
couple hours before a meal
• Monitor your weight about every 2
weeks, and keep track on a calendar
Carmel Corn
One of my family favorites, as well as easy!
2 sticks butter or margarine, melted
½ cup dark Karo syrup
2 cups packed brown sugar
Mix above ingredients in a medium saucepan and stir in ½
tsp salt. Bring to boil, turn down heat and boil for 5 minutes
without stirring. Take off heat, add 1 tsp vanilla and ½ tsp
baking soda.
In a brown paper bag, add two batches of popcorn (regular
popcorn from a popper). Stir above mixture into bag with
popcorn and stir well to coat. (Can add peanuts) Place bag in
microwave and microwave for one minute. Take out bag and
shake well. Return to microwave for another minute, then
shake bag again and return to microwave for one additional
minute and shake well. Open bag and spread out contents to
cool and set. Then place in airtight container.
Chocolate Chip Dip
1 stick butter or margarine
¼ tsp vanilla
2 T brown sugar
1- 8 oz package of cream cheese
¾ cup powdered sugar
¾ cup mini chocolate chips
Beat butter or margarine, cream cheese and vanilla with
mixer. Add powdered sugar, brown sugar and mini chocolate
chips and stir. Serve with Honey Graham Sticks or Chocolate
Sticks.
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Kecia’s Korner
Travel Tips
checkpoint; however you must have insulin with you in
order to carry empty syringes through the checkpoint.
• Lancets, blood glucose meters, blood glucose test strips
can be carried through the security checkpoint.
• Notify screeners if you’re wearing an insulin pump and
ask if they will visually inspect the pump since it cannot
be removed from your person.
• Insulin pumps and supplies must be accompanied by
insulin with professionally printed labels described above.
• You can ask for your items to be visually screened, but
nebulizers and other medical devices may be tested for
chemical residues and X-rayed.
• Make sure that you are prepared to keep medications
refrigerated if necessary (e.g., Tobi, Pulmozyme,
insulin). Pack a quick freeze pack to keep refrigerated
medicines cold and use an insulated container. If you will
be traveling without access to refrigeration, you might
consider buying a portable 12 volt refrigerator. Several
models are available for $50.00 or so that can be plugged
into the 12 volt electrical outlet in your automobile, and
some have adaptors that will allow it to be plugged into
a standard 120 volt outlet. If you are traveling to Europe,
remember that you will need a step-down transformer
(not just an adaptor) or you will overload the appliance
(unfortunately, we know this from experience). We took
a refrigerator with us as a carry on last summer, and
plugged it into standard outlets in the airports in between
flights.
Travel can often leave a lot of sedentary “down time,”
so make sure that you find some ways to be active and build
some exercise into your trip. Just as importantly, many of us
try to pack too much into our vacations. Rest and relaxation
are especially important; you don’t want to come home
exhausted because you overdid it. Oh yeah… and have fun!
Christopher Calhoun and David Entwistle
So you want to see the world… or Disneyworld.
Traveling, whether for vacation or business, can be fun,
but people with cystic fibrosis need to take a few extra
precautions. First, you need to make sure that you are
healthy enough to travel – this is especially important if you
are planning to travel by air and have significantly reduced
pulmonary function. You should discuss your plans with your
doctor to make sure there are no exceptional concerns.
If you will be staying in a hotel, make sure that you
book a non-smoking room. If you have medications that
need to be refrigerated, find out in advance if your room has
a refrigerator to keep meds in. You can use a cooler and ice,
but that’s not ideal.
Take a list of all the medications that you use regularly,
as well as those that you use on occasion. Make certain
that you have an adequate supply of medicines and medical
supplies, both for your trip and until you can obtain refills
when you return. (Don’t forget prn meds – your inhaler
won’t do you much good sitting in your cupboard at home if
you need it!).
If you will be traveling by air, the FAA requires that all
medications be “properly labeled (professionally printed
label identifying the medication or a manufacturer’s name or
pharmaceutical label).” Some people recommend having a
letter from your doctor listing your diagnosis and medications;
you may or may not need such a letter if you are traveling
to another country. It is advisable to put all medications in
a zip-lock plastic bag to make inspection easier. Given that
medications and supplies can add up, it is important to know
that “The limit of one carry-on bag and one personal item
(e.g. purse or briefcase) for each traveler does not apply to
passengers with disabilities; medical supplies, equipment,
mobility aids, or assistive devices.” However, you will need
to identify yourself as having a disability to qualify for this,
and you should check with your airline in advance to ensure
that it cooperates with ADA guidelines regarding this.
Additionally, when packing your meds, make sure you have
a separate and ample supply in a carry-on other than what
is packed away. If you have layovers, cancellations or
something happens to your bags which contain your main
supply, you’ll need an emergency supply until you and your
bags are reunited. Remember once your bags go through
security and your bags are checked, you won’t see them until
you get off the plane.
Security is something else to think about. When going
through security, give yourself and extra 20-30 more than
anyone else would. Here are some important tips from the
FAA:
• Notify the screener that you have a medical condition and
are carrying your supplies with you.
• Make sure insulin (vials or outer box of individual doses),
jet injectors, pens, infusers, and preloaded syringes are
marked properly (professionally printed label identifying
the medication or manufacturer’s name or pharmaceutical
label).
• There is no limitation on the number of empty syringes
that you will be allowed to carry through the security
STOP the Spread of GERMS
Germs are everywhere in our environment. People with
cystic fibrosis must be extra careful to prevent the getting
germs from others in order to keep healthy lungs & prevent
infections. Germs can be spread in many ways including
direct contact (handshaking, kissing, sharing a drink, etc) or
through the air by coughing, sneezing or nose blowing.
It is important for you to help your child be aware of
ways to keep healthy, by stopping the spread of germs. Good
handwashing (or using gel sanitizer), cleaning nebulizers
and not sharing personal items with other people who have
CF or people who are known to be ill. CF patients should
remember to keep at least 3 feet or arms length distance
from other people with CF. When your child is hospitalized,
they should wear a mask at all times when they are out of
their room, and be careful not to share things with other CF
patients, even game pieces or even a bag of popcorn!! Some
germs can live on surfaces like countertops for up to a few
days.
This is a very difficult thing to do sometimes,
particularly for our teen patients, but the floor staff and CF
center staff will help make accommodations so that the
hospital stay can be SAFE and fun.
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University of Missouri CF Research Updates
Looking for New Drugs....A New
Collaborative Study at MU
that will search large databases for similar compounds which
can be tested. The second step involves a laboratory (Dr.
Hwang’s) that determines whether the drug is specifically
acting on DF508. The third step involves a laboratory (Dr.
Clarke’s) that determines whether the drug is nontoxic and
works in a mouse model of CF. In addition, our collaborator
at the University of Utah (Dr. Gawenis) will make new
mouse models where the human DF508 has been inserted
and the normal mouse gene is deleted, which will be better
models for CF drug testing.
Early success with some compounds suggest that a drug
can be found and it is anticipated that the recognition that
results from such a discovery will provide a strong impetus
for formalizing future orphan drug searches.
Lane Clarke, DVM/PhD
“Orphan Drug and Animal Model Development for
Cystic Fibrosis” is a collaborative basic science research
project lead by Dr. Lane Clarke, DVM/PhD. Dr. Clarke and
investigators T.C. Hwang, MD/PhD, and Xiaoqin Zou, PhD,
at the University of Missouri along with Lara Gawenis,
PhD at the University of Utah, are working on this study
first initiated with a two year start-up grant from the Cystic
Fibrosis Foundation. The description below is extracted
from the Missouri Life Science Trust Fund Research Grant
Application they submitted to support the next stage of this
research for new drugs for cystic fibrosis.
This project will involve a team of interdisciplinary
scientists from MU and the University of Utah in a drug
discovery effort for treatment of the underlying defect in the
human disease cystic fibrosis (CF). Although CF is a major
genetic disease, the patient population is relatively small
(25-35,000 patients) so large drug companies do not find it
profitable to engage in research and development for this
disease. Specific drugs used in treating CF are considered
“orphan drugs” because it is very unlikely that they will
eventually be used on large patient populations.
In 2006, the Cystic Fibrosis Foundation provided
funding to form teams of researchers to search for potential
drugs and the MU team was selected. However, the trust fund
of the CF Foundation has been devalued by current economic
conditions and will not be able to continue to support this
important effort after December 2009. In the first two years
of development, the team has become operational through
the development of assays and through the coordination of
different laboratories. If the next three-years of research are
funded, the team will not only engage a fully operational
program in the search for CF drugs, but also, the search
process that is developed can be utilized to search for other
orphan drugs to treat diseases with small patient populations.
Thus, there is both the potential to find a cure for CF, as well
as, develop an orphan drug search paradigm to benefit other
diseases.
CF is a major genetic disease that affects the lungs,
pancreas, liver and intestine resulting in organ failure and
a severely shortened life span. The major mutation in the
CF gene (DF508) allows the protein to be synthesized in
affected organs but destroys the protein before it can become
functional. Remarkably, it has been discovered that DF508
can be rescued from destruction by certain compounds that
were discovered by high-throughput screening (supported
by the CF Foundation). However, these compounds were
identified under very non-physiological conditions.
The purpose of the MU team and this project is to take
the potential drugs from high-throughput screening and
determine whether the drugs affect DF508 selectively and
have desirable pharmaceutical properties. The first step
involves one laboratory (Dr. Zou’s) that has created software
Xiaoqin Zou, PhD
Assistant Professor, Physics &
Biochemistry Depts
Lane Clarke, DVM/PhD
Professor, Biomedical
Sciences Dept
T.C. Hwang, MD/PhD
Professor, Medical Pharmacology & Physiology Dept
Photo taken during sabbatical leave in Taiwan
Drs. Clarke, Hwang, and Zou are part of the Cardiovascular Research Center. For more information see the Center website: http://dalton.missouri.
edu/. The Center, known as “Dalton”, “seeks understanding and information about some of the most prevalent health issues of the day - hypertension; heart disease; adult-onset (Type II) diabetes; obesity; muscular
dystrophy; cystic fibrosis; and breast, uterine and prostate cancer. Teams of
investigators from medicine, engineering, biomedical sciences, veterinary
medicine, physiology and other disciplines work together to find answers to
questions that will directly affect the understanding of disease prevention
and treatment.”
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Using the Lab to Understand What’s
Going on in the Lungs in CF and Test
New Ideas as to What to do About it …
areas including: detection of lung cancer, assessment of
asthma and CF, evaluation of chronic obstructive pulmonary
disease, and others.
We are excited about the new CF exhaled breath
research now going on at the University of Missouri. Be
on the lookout, as we will be requesting volunteers for our
study. Those who volunteer will have the hard or difficult
job of sitting on a chair for 10 or 20 minutes while breathing
through a mouth piece. Dr. Guajardo has done this multiple
times with the major side effect being a severe attack of
boredom. We may need to integrate games such as solitaire
or sudoko to make sure none of the volunteers get hit with
a boredom attack. Joke aside, we hope this study will
contribute to the development of new techniques to noninvasively evaluate what’s going on in the lungs!
Jesus Guajardo, MD/MHPE
Part I: Exhaled Breath
With the advancement of technology new methods
for assessing disease have surfaced. Now-a-days there is
equipment capable of detecting and measure very small
concentrations of substances in fluids and it is this type of
equipment that is starting to be utilized to analyze breath.
Yes, breath, the very air we breathe out. Dogs have had
it right for long time to the point that currently some
researchers are utilizing the very sensitive noses of dogs to
detect cancer just by the smell it produces. Well, hopefully
with time and the development of new technologies we
will be able to surpass that canine ability and be capable of
detecting changes in health much earlier than we are able to
today. Just imagine having a whole medical evaluation by
breathing out into a machine!
Though Dr. Guajardo is now practicing medicine in Texas,
he will be collaborating with Drs. Tom Mawhinney and
Deborah Chance at the University of Missouri as they
continue pioneering in this new area with the help of Dr.
Peter König and research nurse Donna Smith.
Part II: Studying and Treating CF Pathogens
“As They Live”
Everyone familiar with cystic fibrosis knows that airway
infections are a major problem in this disease. Folks with
CF, and those who treat CF infections, know all too well that
bacterial infections are often very difficult, and sometimes
impossible, to eradicate. While there are antibiotics that test
very well in the laboratories on bacteria that come from CF
sputum, these don’t always work well within the CF airway.
To tackle the question of how to help improve clearance of
these infections, basic scientists such as Drs. Chance and
Mawhinney have teamed up with physicians and patients to
try to study CF pathogens “as they live” in the CF airway.
Dr. Guajardo testing an early prototype exhaled breath
condensate (EBC) collecting device.
Currently at the University of Missouri we are working
with the now available, very sensitive technologies to
analyze exhaled breath condensate (EBC). EBC is obtained
by having patients breathe through a mouth piece into a
condenser for 10-20 minutes which results in the collection
of one to two milliliters of liquid (~ 1/15th of an ounce).
The breath goes into a cold chamber and condenses into a
liquid that accumulates in the sample holder. The sample is
then frozen and taken to the biochemistry labs where stateof-the-art analyzers will check for different substances in
the fluid. Studies conducted so far are starting to shed some
light regarding the chemical nature of EBC. It seems that
infections, such as those found in cystic fibrosis (CF) lungs,
make the EBC more acidic (low pH) and that inflammation
itself can be detected by specific patterns of small molecules
and by the concentration of specific cellular products
(cytokines). At MU projects are being developed in many
Deborah L. Chance, PhD
Molecular Microbiology & Immunology/Child Health Depts
At MU, some of our simple findings about the bacteria
that come from CF sputum include: that they can live for
long periods of time under conditions which we would not
have thought possible (such as at very high pH or without
fresh nutrient supplies); and that when an individual has
an infection with two or more bacteria at the same time
8
(polymicrobial infection), these bacteria can “co-colonize” a
space and appear to look as if they are happily living together
in a mixed bacterial community. Laboratory observations
suggest that bacteria can physically change themselves in
order to adapt to environmental conditions. In addition to the
physiological conditions that the CF airway provides related
to the CF airway cell problems of CF, these conditions may
include long term exposure to drugs and to other organisms.
Current studies in our laboratories are focused
on understanding how bacteria such as Pseudomonas
aeruginosa and Staphylococcus aureus adapt to survive
in their environment. Specifically, we are looking at the
way the bacteria adapt their metabolism and their cell
membranes in both CF and CF-like growth conditions.
With the state-of-the-art instrumentation and technologies
which we are now using to look at small molecules in the
exhaled breath of people (as EBC), as described above by
Dr. Guajardo, new research has also begun to determine
what molecules the bacteria place into their airspace that
may describe how they are living (under stress, under low
oxygen conditions, in biofilms, etc). These same compounds
in the body may be affecting nearby human cells or bacteria.
Through the development of new, sensitive techniques using
tools like a gas chromatograph-mass spectrometer, an ion
chromatograph, and a liquid chromatograph-high resolution
mass spectrometer, we will search for such biomarkers
that can be detected in the vapors above the bacteria. Once
identified, these signature molecules may also be detectible
in the human breath (EBC). As a result, these data may give
us a clearer indicator of infection, and potentially yield more
information on how, in the patient, the bacteria are thriving
(i.e. growing rapidly under good oxygenation and nutrient
conditions), or surviving (i.e simply maintaining viability or
growing slowly in biofilms or under anaerobic conditions).
Ultimately, achievement of this goal would help enable
physicians to choose drugs which best attack the bacteria “as
they grow”.
In addition to chemical signatures of metabolism and
adaptation in the airspace above the bacteria, our laboratories
are also investigating changes that occur in the chemistry
of bacterial membranes. Such changes in the membrane of
Pseudomonas aeruginosa (PA), for example, may alter the
effectiveness of drugs against it and/or enable it survive with
other bacteria. Currently we are focusing on one particular
type of molecule found within the Pseudomonas membrane,
that is “lipid A”. Lipid A is a complex molecule of different
fats and sugars that is part of a larger structure found in most
types of gram negative bacteria called lipopolysaccharide
(commonly referred to as LPS). Lipid A serves to hold the
LPS in the bacterial cell membrane. Lipid A is an important
bacterial molecule for the human to detect, as it triggers a
number of immunological responses to rid the body of the
microorganisms. PA in CF appears to be able to alter its lipid
A composition, possibly helping it persist in the CF airway.
Dr. Mawhinney is currently chemically synthesizing different
versions of lipid A. These rare “laboratory standards” will
then be used to help in our studies of what the lipid A of
CF PA looks like directly from the patient. Additionally,
Thomas P. Mawhinney, PhD
Biochemistry & Child Health Depts
possessing these standards will aid significantly in our
investigations on Pseudomonas aeruginosa and how lipid
A may be altered in its composition in the laboratory when
challenged with different growth conditions, such as with
limited oxygen supply; in co-colonization studies (i.e. while
living in mixed species communities); and when exposed to
subinhibitory levels of antibiotics. PA has been observed to
alter its “phenotype” (how it looks) under different growth
conditions, and in ongoing studies we will see whether
some of that “look” may reflect changes in the membrane
composition and its ability to survive the new environmental
conditions.
The newest important CF project in our laboratories,
lead by Dr. Chance, is the screening of essential oils (the
oily steam-volatile extracts from plants) for antimicrobial
activity against CF pathogens. Many of them you may know
of as being used in “aromatherapy”. Extracts of plants have
long been known to provide a variety of health benefits, and
so the possibility that some of the volatile components of
some essential oils might be useful as inhaled antimicrobials,
or in combination with other antibiotics in CF, is under
investigation. While this project is still very young, we
have found several oils which may be potentially useful.
These, and the individual chemicals within the oils, will be
studied in more detail when the initial screening of the large
collection of oils is complete.
So stay tuned folks. There is a lot of good CF research
going on at MU. Thank you to all of you who volunteer
for studies, who contribute samples, and who support and
encourage CF research. Whether your support is through
local, state, and national means, you do make a significant
difference. Great strides have been, and continue to be made,
by basic science research along-side clinical studies around
the world to improve our understanding and treatment of
cystic fibrosis.
Deborah Chance, PhD and Thomas Mawhinney, PhD
9
Sharing Spot
Cystic Fibrosis Lifestyle FoundationPromoting Healthy Lifestyles
scholarship committee would like to encourage all cystic
fibrosis patients, parents and siblings to please apply for
these scholarships. Even though it is not a lot of money, it
is very helpful and the scholarship is renewable each year.
Deadline is March 1, 2010.
Lois Frazier
Physical exersize and activity is healthy for everyone,
particularly for people living with cystic fibrosis. Evidence
suggests that people with CF who participate in aerobic &
strength training can improve lung function and overall strength.
CFLF assists in providing avenues toward healthy and
active lifestyles through recreation, thereby educating
adolescents and young adults with cystic fibrosis on the critical
psychological, social and emotional connections between their
lifestyle and their health. They provide $500 recreational grants
to help people with CF pursue their goals of leading a physically
active lifestyle. They provide “recreation” grants directly to
the agency, not the patient. Whether you enjoy swimming,
kickboxing, hiking or biking, CFLF wants to help you reach
your goals. For more information or to download an application,
go to their website www.cflf.org
CF-Related Scholarship
Opportunities 2010
Giulio Barbero Memorial Scholarship
2010-2011 deadline March1, 2010. For an application
as a CF patient or family member, call CF Center in
Columbia MO, 573-882-6978.
Cystic Fibrosis Scholarship Foundation
2010-2011 deadline March 21, 2010. www.cfscholarship.org
Boomer Esiason Foundation CF Ambassador Scholarship
Awarded quarterly. www.cfambassador.com
Elizabeth Nash Foundation Scholarship Program
2010-2011 postmark deadline April 5th, 2010.
www.elizabethnashfoundation.org
SolvayCARES Scholarship
Applications will be posted late January.
www.solvaycares.com
2009 Scholarship Winner
Cystic Fibrosis of Missouri, West Plains Chapter is
proud to announce this year’s winner of the 2009 Dr. Giulio
Barbero Memorial Scholarship. This year we have one
renewal cystic fibrosis patient winner.
The committee would like to take this opportunity to
thank all the applicants for taking the time to apply for our
scholarships. We would also like to say a very special thank
you to Tony North in Dr. König’s office for assisting us with
this process. We are so very grateful to our special donors
this year, Mrs. Marj Barbero and Mrs. Lea König.
Sophie Backes, the daughter of Gary and Mary Backes,
Linn, Missouri is a 2004 graduate of Osage County R-II,
Linn, Missouri. She has completed her fifth year at the St.
Louis College of Pharmacy, St. Louis, Missouri.
Backes is very active in raising money for the American
Heart Association, Relay for Life and for Cystic Fibrosis
Association of Missouri Hoof-A-Thon. She is also a very
active member of St. George Church.
Backes states “I have been blessed with good health for
the past few years, for which I am very grateful as my classes
at STLCOP have become progressively more challenging... I
am excited to say that the end is in sight at this point.”
Backes is awarded a $1,000 scholarship to be used at
the college of her choice. She is a wonderful example to all
of us. She set her goals high and has worked very hard to
reach them. We look forward to her graduating in May, 2010
from St. Louis College of Pharmacy and also look forward to
her career as a pharmacist. Just think, some day she may be
passing out the medication that cures cystic fibrosis!
Dr. Barbero would be so very proud Sophie Backes. He
always felt like no matter if you were the patient, parent or
sibling, you should live life to the fullest. He believed that a
person could overcome the biggest mountain and the lowest
valley with God’s help. By looking at Backes and her family,
you know Dr. B. must have be right.
If you would like to be a scholarship winner for the
school year 2010-2011, please contact Tony in Dr. König’s
office and he will be glad to send you an application. The
Jessica’s Story
This link will get you to a short video of Jessica Joyce’s
story, as she and her Mom were interviewed by the transplant
folks at Children’s Hospital in St. Louis. As one friend
affected by CF wrote “Jessica’s story is great and definitely
one that gives hope to so many of us!”.
http://www.youtube.com/watch?v=QqNC5-roSRM
Health Benefits of Owning a Dog
As we all know, diet and exercise are important ways
to keep our bodies healthy. But there’s one more thing that
helps you stay healthy….owning a pet. Most people consider
getting a pet and think they are too much work. That’s true.
But, the positive aspects of owning a pet far outweigh the
negative ones. Owning a pet can lower blood pressure,
increase immunity, and keep you from becoming depressed.
Studies have shown that pet owners have an increased life
span versus people who do not own pets.
Perhaps one of the greatest benefits of owning a dog
is that they demand exercise. Taking your dog for a walk
means that you are walking too. Exercise is so important
to staying healthy and your dog will not allow you to miss
a day of exercise. Having other animals that do not require
exercise are still beneficial. Developing a relationship with
a pet provides people with a reason for enjoying life and
connecting with others.
If you have CF or have had a transplant, there are special
considerations to think about when owning a pet.
• Make sure your pets eat high quality food and drink only
clean water. Keeping your pet healthy can help you stay
healthy.
• Never allow your pet to kiss you on the face.
10
see me. They keep me happy
and healthy.
All of my pets are rescue
animals and I encourage
you to visit your local
animal shelter to rescue
a dog or cat that needs a
good home. Often adult
pets are a better choice for
immunocompromised persons
as puppies and kittens are at
an increased risk for shedding
bacteria in their feces. They will be forever grateful to you
and provide you with many years of love and laughter.
Jill Roberts, (Jenks, OK)
• You should not permit your pet to sleep with you.
• Cats are ok, but someone else in the household should be
responsible for changing the kitty litter as there is a risk
for toxoplasmosis.
• Birds can carry parasites so it is not recommended to
clean the birdcage or handle the bird.
• Wash your hands after petting or playing with your pet,
especially before eating.
• Develop a close relationship with your veterinarian and
make sure your pet is current on all vaccinations.
My home is taken over by two dogs and a cat. They
run my home and they provide me with much joy. When I
am sad, they cheer me up. When I am lonely, they give me
company. When I am sick, they lay with me. When I am
excited, they are excited with me. They are always happy to
CF Events 2009
Spring CFAM Meeting 2009:
Learning to Breathe Away Stress
The Spring CFAM
meeting was held in West
Plains, MO, on March 21,
2009. Billie Hutchings, a
local West Plains Therapist,
was the guest speaker.
She went over a packet
of information about how
stress affects the body
and how to reduce stress
levels. Illustrations involved
getting the group to actively
participate in some deep
breathing exercises and
2009 CFAM Officers, front row: Sally
breathing through straws,
Hicks (left), Secretary; Jennifer
which at least got the group Wharton (right), Treasurer; back row:
laughing and cajoling,
Mary Backes (left), Vice President;
Mary McCutcheon (right), President.
whether or not any stress
(not pictured: Mike Pratt, Historian)
was lifted!
The regular business portion of the meeting included
discussing the Music Show, Bass Tournament, and the
election of officers. Mary McCutcheon and Sophie Backes,
who were both scholarship winners in 2008, updated
everyone on their progress. Tim Stanfill spoke about the
generous donation of a handmade angel for our auction,
11
made and donated by a man who lost loved ones to CF, also
in memory of Chris Douglas.
After the meeting concluded, we all had a good time
drawing for door prizes. Everyone got something to take
home. Joe Diffey came in to sign autographs and pose for
pictures, and get us psyched up for the show, and the firemen
and stage hands who help out with the Music Show came in
to relieve us of some of the abundance of leftover food. Yes, I
couldn’t write this without mentioning the food . . .
Sunday. The Front Show has been
made up of Jessica’s Friends since
the beginning. Thank you for
caring enough to be willing to put
in the extra effort and dedication
to perform. Under the direction
of Diane Reed and her assistants
Audrey Ann and Julie Ann Reed,
the children and teenagers did an
unbelievable job. The crowd loved those cowboy hats and
each one of you did a great job entertaining them.
We feel very fortunate to have a place like the Civic
Center to have our Music Show each year. Carl Johnson and
all of the staff are so helpful and easy to work with. Thank
you for always going the extra mile for us.
The Howell
County Rural Fire
Department volunteers
do so much more than
fight fire. They are
always there when they
are needed, willing to
volunteer to help out no
matter what the task is.
Thank you so very much.
At a time of great loss of their loved ones, many families
continued to remember cystic fibrosis victims. Thank you for
your unselfish love and conviction in helping us find a cure.
Billy Sexton, Brenda Guilliams, Bo Pace, Robbie
Crites, Russ Gant, Bill Cates, Glen Johnson, and Mark
Collins did a
wonderful job with
our auction. Also,
Linda Cates, Carol
Johnson, Diane
Adams, Libby
Grisham, Kelly
McGinnis and the
CF families did an
awesome job running
And for those of you who didn’t make the meeting or
left early, you missed an excellent presentation by Tom and
Deborah about research with essential oils, which seems
to have the possibility of opening all kinds of new doors to
treatments in the future. Thanks to our researchers and all our
members who support the effort by attending our meetings!
Sally Hicks, Secretary CFAM
21st Annual Cystic Fibrosis Music Show
For 21 years a group of local and loyal friends, Brenda
Land, Julia Sheldon, Joe & Gayla Auffert, K-Kountry 95
Radio Station, Jess & Patsy Atkinson, Brenda Guilliams,
Linda Cates, Libby Grisham, Sara Manville, Crystal Cantrell,
Stacy Auffert and others band together, dedicated to work
hard to find a cure for cystic fibrosis. They are still working
as hard today as they did in the beginning. We appreciate
your love and support.
Once again our many sponsors answered the call, to make
donations to help our effects. This year was great because
of you. We appreciate your support especially through these
tough times of our economy. Bob Eckman and Lynn Hobbs
and K-Kountry 95, Harlen Hutchinson and The Ozark Radio
Network, Ed Martin and KHOM, Carol Bruce and the West
Plains Daily Quill, Sunie Pace and the Horse Trader all did
an out standing job promoting our Show. Steve Stewart and
Vicki Smith at ColorTech Printing did a wonderful job on our
posters, tickets and programs. Thank you Myles Smith for
doing a fabulous job at being our MC. Thank you to all the
businesses and individuals that took their time and effort to sell
our tickets, what a wonderful job you did.
We appreciate Becky Lott and the West Plains
Elementary School for helping with our practices each
the silent auction. Thank you for donating and purchasing
our items. Cheryl Thompson by selling tickets on the bicycle
and Julie Miller by helping sell roses added something very
special to the evening’s events. These four extra events raise
a lot of money each year.
To each and every one of you that purchased tickets,
thank you for making this a huge success. We appreciate
12
you all standing
in line to get in
and waiting for
the Show to get
started. There is
no greater joy
to everyone that
works so hard on
the Show to look
up and see so
many of our old
and new friends
there supporting
our efforts.
Many of you
come every
year and this
may be the
only concert
you will attend.
Many are
friends of our
families and some
have become our
friends through
this effort. Thank
you for coming
and showing your
support.
Thank each
and every one of
you for the part
you played in
our 21st Annual
Music Show.
Because of your love, we raised $33,500 in an effort to find a
cure for cystic fibrosis. With your help, this gives victims and
their families hope.
Our family feels that God has blessed us very richly by
surrounding us with such loving and caring people from all
walks of life. You took us into your hearts and for all these
years, never gave up on us and our dream of finding a cure
Silent auction volunteers
for cystic fibrosis in Jessica’s lifetime. THANK YOU!
If you were unable to attend this year’s event, please mark your calendar for March 20, 2010 for the 22nd Annual Cystic
Fibrosis Music Show. It is sure to be a weekend packed full of fun.
Cystic Fibrosis Association of West Plains
Victims & Families of Cystic Fibrosis
Rick & Lois Frazier and Jessica
13
24th Annual Buddy Bass Tournament
Another Success Story
Pace, Jason Willard, Waco Johnson, Robert Burtrum and
Fred Hale work several months to pull this event off each
year. We also appreciate our partnership and friendship with
Rick Pierce and Bass Cat Boats. Each year their donation
of a Bass Cat Boat and Trailer with a Mercy Motor helps to
make our Tournament what it is today.
We would also
like to think Falcon
Rod and Ardent Reel
for the donation of a
rod and reel for us to
auction off. Thank you
also to everyone that
helped out by selling
the raffle tickets for
us. We raised $1,509
What a
wonderful
day it was on
Saturday, April
25, 2009. Even
though the
Tournament
did not start
until Saturday
morning, the fun
began on Friday
night with the
celebration of getting to see all of the cystic fibrosis families
and friends and getting another chance to eat at Fred’s Fish
House in Mtn. Home, Arkansas.
We all gather in the atrium waiting for assignment for
the upcoming day’s events. Some chose to get to bed early,
while others hung around to see who could stay up the latest.
Paul Shasserre is giving Ruth Ellison and Lois Frazier a run
of their money these days in this area.
The weather was a little windy, but the temperature was
wonderful. It had been a long time since everyone was not
freezing that morning. We had 295 boats in the tournament.
With 154 of them returning to weigh in fish. There was a
total of 601 fish weighed in with a total weight of 1,314 lbs.
First place winners were Kyle Pressley and Justin
Yarbrough, Harrison, Arkansas with 15.50 lbs. They won
a 17’ Bass Cat Phelix Boat and Trailer and a Mercy Motor
on the raffle. Rick Callahan was the winner this year of the
rod and reel.
We would also like to
thank Ozark Awards, West
Plains for their donation of our
trophies again this year.
We would also like to
thank everyone that worked at
the Cook Shack. Marvin Ball
and Jim Conner did an excellent
job cooking the burgers while
Irene Frazier, Marie Hensley,
Sally Hicks and Naomi did a
great selling them. They sold
them faster than they could
cook them this year. While
Duane Hensley and Jessica
Joice were busy selling them
something to drink and adding a raffle ticket on the side.
donated by Bass Cat Boasts of Mountain Home, Arkansas
and $2,000.
Second place winners
were Fred Hale and Waco
Johnson, both of West
Plains, Missouri with 15.15
lbs. They won $1,000.
Big Bass winner was
Danny Holmes and Jared
Hambelton, Gainesville,
Missouri weighing in a
5.44 largemouth bass.
They won $1,085.
Many people like Dan
& Rhonda Singletary, Bo
14
Others
helping at
the weigh in
was Larry
Carney and
Debbie
Shasserre
on the dock
with Austin
Ball, Kyle
Armor, Paul
Shasserre, Otis & Ricky Hostettler all at the fish tanks with
Jennifer Wharton, Brenda Guilliams, Mary Kay Ball, Maizy
Hicks, Deborah Chance and Rhonda Singletary helping
out. Jason Willard and Robert Burtrum weighing the fish
in and Roy Hicks, Jim Bax, Jess Atkinson, Jake Shasserre,
and Bill Manville carrying the fish. If you don’t think fish
are heavy, just ask one of them after carrying 154 baskets of
fish. We are
very grateful
to the ladies
in the van,
Diane Carney,
Jeannie Bax,
Ruth Ellison,
and Sandy
Connor. They
are the ones
that have to
keep all the
figures straight for us and the fishermen.
Hope you enjoy all the wonderful pictures that Tom
Mawhinney and Maizy Hicks took. They really got some
great shots, (for more photos, see website www.hope4cf.
com).
Before sunrise and after the sunset, people were busy
talking, laughing, and having fun while they worked hard
in an effort to take another step into trying to find a cure for
cystic fibrosis. They did an excellent job at it too. We raised
$14,200 this year adding to our total raise in the 24 years to
$275,000. Thank you to each and every one of you that took
a part in making this happen. We all have to do what we can
no matter how little or big that part is. Together we can find
a cure.
If you are reading this article and wish you could do
something like this, please come and join in on the fun in
2010. New people are always welcome and remember each
of us were new at one time or another. Before you know
it, you will be like Roy, Sally and Maizy Hicks. They just
realized this year that they have been coming for five years
now and had to give up the new comer award. Trust me, this
is a wonderful time and God has always blessed our efforts
and kept us safe.
Lois Frazier
15
CF Walk ’09
CFAM Summer meeting 2009
On May 2, 2009,
CF families and friends
came together for the 4th
Annual Columbia Great
Strides Walk. The walk,
coordinated by a local steering committee in conjunction
with the Gateway Chapter of the Cystic Fibrosis Foundation,
raises money to support research and other functions of the
Cystic Fibrosis Foundation. This year’s walk featured a
barbecue, raffles, educational booths and entertainment by
the Boone High Steppers. The beautiful weather and great location at Stephens
Lake Park brought out approximately 250 walkers and raised
over $25,000 for the foundation. We also welcomed 7 new
walk teams. Combined with returning teams, there were 25
walk teams participating.
The Great Strides Walk is a great way to meet other
families impacted by Cystic Fibrosis and to help support the
fund-raising efforts of the foundation.
The summer meeting of CFAM was held June 27, 2009
in Springfield, MO at the Doling Park and Family Center,
and was hosted by Mary McCutcheon. We had about 16
people in attendance for some good discussions and good
time to share in the events of each other lives.
Rick Frazier gave updates on the 2009 Music Show with
Joe Diffie & the Fishing Tournament. Dr. Jesus Guajardo
talked about the new breath research study with the research
lab. Dr. Tom Mawhinney and Dr. Deborah Chance gave
slide presentation updates on their research studying the
chemistry of Pseudomonas and on essential oils as possible
antimicrobial agents for CF bacteria. Tammy Wilson sent
posters and information on the Fast Lanes Motorcycle Rally
to be held on July 18th in Chillicothe, MO. (See article to
follow). We were reminded that the CF Awareness Day in
Columbia was set for November 14, 2009.
Thanks to all who came and shared. Looking forward to
seeing our CF friends again in West Plains at the Spring 2010
meeting.
Mary McCutcheon, President CFAM
Motorcycle Rally for CF
A Fast Lanes Motorcycle Rally for CF was held in
Chillicothe, MO on July 18, 2009. The event was hosted by
Tammy Wilson & family along with Fast Lanes Fun Family
Entertainment Center, Chillicothe. There were 27 bikes with
32 riders. They rode about 90 miles round trip. We sold
raffle tickets, 50/50 tickets, and t-shirts. There were vendors
set up for different biking apparel and such. You could even
go indoors to bowl a few games if you wanted to get out of
the heat. There were a few bands, one which was an allteen group, along with a DJ. “Angels in Waiting” performer
Tammy Cochran who sang for an hour. The rally was a new
16
Highlights from the North American
CF Conference 2009
Sponsored by the Cystic
Fibrosis Foundation, the
Annual North American Cystic
Fibrosis Conference (NACFC)
was once again a bit hit in
October ‘09. The Conference
was held in Minneapolis, MN
and had a great turnout ( ~
3500 people) even with the
economic difficulties and the flu
scares. It’s amazing to see how
people from all over the world
are working so hard in the CF
Downtown Minneapolis
field as caregivers, researchers
and volunteers. What a
great chance to share what
has been learned at the
conference.
Attending from our
University of Missouri
Health Care and CF Center
were Dr. König, Dr. Ner,
Connie Fenton, Kecia
Nelson, Christina Korth,
Jennifer Andert , and
Ashley Gage. Ashley Gage,
MSW, and former CF social
work intern, presented a
case study in motivational
Ashley Gage and Kecia Nelson
interviewing & problem
solving for a lively panel
discussion with other CF social workers. Researchers from
MU included Lane Clarke, DVM/PhD from the Dalton
Cardiovascular Research Center, and Deborah Chance, PhD
from the School of Medicine.
Among the
highlights of the
Conference were plenary
session presentations on
hopeful new treatments
that are already in the
drug development
pipelines of clinical
trials. These include
inhaled antibiotics, and
compounds that may
ultimately help the
body with certain CFTR
NACFC - not just for North Americans.
mutations to get a larger Poster session photo of new acquaintance
from Italy, studying similar types of comquantity of functional
pounds as we are at MU.
CFTR protein to the cell
surface to do its job.
On the basic science side, as each year, so very many
labs are contributing small pieces toward the still puzzling
parts of this CF story. The CF pig model is now a reality.
and fun experience. I met three CF families during the day
and a bunch of soft hearted, generous bikers too.
Mary McCutcheon
17
Yes scientists and
physicians now
have pigs with
“CF”, that is with
mutant CFTR genes
and showing the
gastrointestinal
and pulmonary
difficulties of
very severe CF.
Though early on
in the research,
already the animals
are showing
investigators much about how “CF pathology” occurs at
the cellular and organ level. While a lot of work for the
physicians and scientists caring for the pigs, the CF pig
model represents a major advance in the ability to study CF
and progress keenly focused toward the development of new
therapeutic strategies and agents.
The future is looking so bright for making CF an even
better managed disease than it is now. Speaking at one of
the plenary sessions was Dr. Francis Collins, who is now the
Director of the NIH. Dr. Collins shared much enthusiasm
about the progress that has already been made in CF, and
spoke about how the CF world - its patients, care teams,
researchers, volunteers, drug development network, corporate
collaborations, international cooperation, etc.- is so far
advanced and is pointing the way for others to be successful
in battling other diseases, with so many benefitting from the
CF groundwork and role model.
More information on the conference including videos of
the 3 plenary sessions and Dr. Collins’ now famous musical
performance “Dare to Dream”, can be found at the CFF
website link http://www.cff.org/research/NACFC/. Happy
viewing.
Deborah L. Chance, PhD
Cystic Fibrosis Awareness Day 2009
What an educational day we had in Columbia,
MO November 14th at the Garden Hilton Convention
Center. Special thanks to all of our excellent speakers and
representatives from CF drug, vest, and specialty treatment
companies, and for all the behind the scenes efforts of
Connie Fenton, Kecia Nelson, and the rest of the CF Team,
and for the support of many funding sources.
We had two great nationally known speakers, Dr.
James Yankaskas, Co-Director of the Adult Cystic Fibrosis
Center of the University of North Carolina-Chapel Hill and
Kathy Sabadosa, MPH of Dartmouth-Hitchcock Medical
Center on behalf of Clinical Affairs at the Cystic Fibrosis
Foundation. Among other things, they shared with us about
the great progress in CF care across the country and how the
CF Foundation and CF care have developed over the years
to include a large care center network, the very valuable
CF registry tool, and the CF Therapeutics Development
Network (TDN). The CF Foundation is now pioneering a
very successful quality improvement initiative. For more
information see website with seven worthy goals for CF care
quality improvement: http://www.cff.org/LivingWithCF/
QualityImprovement/.
Along with Dr. König, our CF Center Director, we heard
from Michelle Kemp from the Parent’s Advisory Committee
and Lois Frazier from of the Cystic Fibrosis Association of
Missouri. Local speakers in their areas of expertise included
respiratory therapist Natalie Harris, pediatric endocrinology
nurse specialist in diabetes Janeth Todd, dietician Christina
Korth, social worker Kecia Nelson, and researcher Deborah
Chance.
Connie Fenton
Dr. Peter König
18
Kathy Sabadosa
Dr. James Yankaskas
Slide describing a CF cell culture research experiment from
one of Dr. Yankaskas’ talks.
Lois Frazier
Michelle Kemp
Christina Korth
Janeth Todd
Natalie Harris
“The Scoop”: the lead into Christina’s presentation.
Kecia Nelson
Thank you all you could make the trip to Columbia.
We know it is a long distance for many of you. For those
of you who were unable to come, we are hoping to develop
educational materials, in one form or another, from the
speakers’ presentations that can be made available to patients
upon request.
Please consider this as the initial view of the day, and
look for an article to come from “a mother’s perspective”.
Deborah L. Chance, PhD
Deborah Chance
19
Upcoming CF Events
The Pascale’s Pals 12th Annual
Benefit Auction, Dinner & Dance!
room rate as of yet. Also, we will meet (optional of course)
for breakfast the next morning before everyone leaves that
stayed the night.
We are sure you have figured out by now that this
weekend is packed full of fun and laughter. Please mark
your calendar for Saturday, March 20, 2010. If you have any
questions, please contact Rick or Lois Frazier at 417-2565388 in the evening. Look forward to hearing from you!!
Lois Frazier
This year’s event will be held at the Holiday Inn
Executive Center in Colulmbia, MO on Friday, March 12,
2010, starting at 5:30 p.m. For more information please view
the website www.pascalespals.org. Proceeds of the event
benefit our Children’s Hospital patients and their families.
22nd Annual Cystic Fibrosis Music Show
& 2010 Spring CFAM Meeting
Calling All Walkers!
Come join us for our annual Great Strides walk where
taking steps to cure cystic fibrosis goes a long way toward
making a difference in the lives of those with CF. There are a
few different sites where you can join in the fun.
With Spring just around the corner, it is time to start
making plans for the annual events and happenings in the
West Plains area. On Saturday, March 20th, 2010 the Spring
CFAM Meeting and the 22nd Annual Cystic Fibrosis Music
Show are two events we hope you will not want to miss. The
day will be packed full of fun for all that attend. If you have
not been to these events before, we invite you to give them
a try. If you have been before, we hope you had a wonderful
time and will come back again this year.
The 2010 Spring CFAM Meeting will begin with food
and fellowship starting at noon at the West Plains Civic
Center, West Plains, MO. Then about 1:00 p.m will start a
very informal meeting with lots of information. This will
be a wonderful opportunity to meet families from different
parts of the state and to share with one another who know
about what it’s like to have or live with cystic fibrosis. Guest
speakers will be Danny Hobbs, members of the Cystic
Fibrosis Care Team, and Researchers from the University
of Missouri, Columbia, MO. The meeting usually lasts until
about 4:00 p.m.
The 22nd Annual Cystic Fibrosis Music Show’s doors
will open at 6:00 p.m. starting off with a silent auction. Then
at about 6:45 p.m. a live auction will begin. Both auctions are
packed full of donated items that everyone is sure to enjoy. If
you have something you would like to donate, please bring it
with you.
Next up will be the wonderful Jessica’s Friends singers.
This group, made up of local talent, has been performing
each year and they are always a crowd pleaser. This year’s
group will be under the direction of Diane Reed. If you
have a child that would like to be a part of Jessica’s Friends,
please let us know. Everyone is welcome to come and be a
part.
Then when you think the evening couldn’t get any
better, Aaron Tippin will take the stage. He will be singing
some of his all-time favorites like, “You’ve Got to Stand for
Something”, “There Ain’t Nothin’ Wrong With the Radio”,
and in wake of 9/11, his patriotic anthem “Where the Stars
and Stripes and the Eagles Fly”, plus many, many more. This
is a Show that everyone is sure to enjoy. Ticket prices are $15
for adults and $5 for children 12 and under.
There will be an after-the-Show get together at the Best
Western Hotel in West Plains. We will have rooms reserved
in case you would like to spend the night. We do not have the
Columbia, Stephens Lake Park, Saturday, May 1, 9 AM
Jefferson City, Memorial Park, Saturday, May 15, 10 AM
Kirksville, Brashear Park, Saturday, May 22, 10:30 AM
Springfield, Rutledge-Wilson Farm Community Park,
Saturday, October 2, 9 AM
This will be the 6th Annual walk in Columbia and the 2nd
walk for Jefferson City.
Pre-registration is not required but preferred. You can
register a team online at www.cff.org or by contacting Anna
Kusnierkiewicz at 1(800)727-1464 for more information.
Come help us celebrate the new CF medical advances. Enjoy
fun family activities. Lunch will be provided following the
walk.
25th Annual Cystic Fibrosis Buddy Bass
Tournament
Have you ever thought about fishing in or attending a
Bass Tournament before? If not, why not?
If you always wanted to but really never had a good
reason to go to one, we would like to give you a reason
to attend the 25th Annual Cystic Fibrosis Buddy Bass
Tournament. By being a part of this event, you are helping to
save lives.
If you like to fish for bass, we have the perfect place
to fish - the beautiful Lake Norfork, Henderson, Arkansas.
This year’s tournament will take place on Saturday, May 8th,
2010. The boat dock will be full of cystic fibrosis families
and friends by 5:00 a.m. just waiting to greet you. The first
flight will launch at 7:00 a.m. Dan Singletary, Bo Pace,
Rick Frazier and the others that help with the tournament
will make you feel right at home and will be there to answer
any questions you may have before or after the tournament.
You will have the opportunity to either fish in Missouri or
Arkansas, or both if you choose to.
If you do not receive an entry form in the mail, you can
go to hope4cf.com and print it off and mail it in or call Dan
Singletary at 417-256-0055 or Rick Frazier at 417-256-5388
and they will be glad to mail you a form.
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If you want your money to go for a great cause, this
is it. The entry fee is $65 per boat. The first 40 places will
win either money or prizes. 295 boats were in last year’s
tournament. These fishermen and women and friends raised
$15,000 for research for cystic fibrosis. Boy, did they do an
excellent job and had loads of fun doing it. At the end of the
tournament last year, everyone went home a winner. You can
too if you will attend this year.
If you really don’t want to fish but would like to see
what it is all about and help out, there is a job for everyone
and if you are lucky, there may even be two or three. We
are always needing help getting set up for the tournament,
helping with the weigh in, carrying the beautiful fish, writing
out thank you cards, cooking hamburgers and selling drinks
and raffle tickets. The list of fun things to do can go on and
on.
There will be a block of rooms reserved at the Lake
Norfork Hotel. If you would like a room, please contact Rick
or Lois Frazier at 417-256-5388 and they will reserve a room
for you.
So what are you waiting for? The fun can’t start until
you get there, so come on and make your plans to attend the
25th Annual Cystic Fibrosis Buddy Bass Tournament on
Saturday, May 8th, 2010.
Lois Frazier
Quote
“The things that make you strong,
and make you feel as though you’ve
accomplished something, are not the
easy ones; it’s the things you had to
work and struggle through. Those are
what give us our depth -- that make us
not gray and plain and nothing, but give
us depth and texture and longing.”
-Dr. Jerri Nielsen
(she is the doctor that had cancer
that was rescued from Antarctica in
1999.)
hope4cf.com Web Page
The new hope4cf.com web page is up and running. At the present time, we have had over 900
hits on the site. Which is wonderful news. We are still very busy changing and adding things. If
you have not had the opportunity to look at it or if you haven’t visited it in a while, we invite you to
look at it again. Also, please tell your friends and family members about it.
We would love to add any information you would like to share about yourself or an event
you will be hosting in your area. We can add pictures too. We will not be making any doctors
appointments on this site. This is just an informational web page. If you have any ideas that you
would like to see posted on this site, please let us know. You can contact us at special_loe@yahoo.
com. In the subject line make sure you list hope4cf.com.
The web page is being hosted by Jaggar Technologies and designed by Crider Publishing. We
would like to thank them both for all their help in making this possible for us to enjoy. We would
also like to thank Sandy Morgan for taking the Music Show pictures and also Dr. Deborah Chance
and Dr. Tom Mawhinney for taking the Fishing Tournament pictures. We hope you will enjoying
them as much as we have.
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Cystic Fibrosis Association of Missouri and Friends Upcoming Events
Giulio Barbero Memorial Scholarship
SPRING 2010
Application Deadline March 1, 2010
CFAM Spring Meeting & Music Show
West Plains Civic Center,
West Plains, MO
March 20, 2010
Great Strides CF Walk - Columbia
Stephens Lake Park
Columbia, MO
May 1, 2010
CF Buddy Bass Tournament
Lake Norfork
Henderson, AR
May 8, 2010
Great Strides CF Walk - Jefferson City
Memorial Park
Jefferson City, MO
May 15, 2010
Great Strides CF Walk - Kirksville
Brashear Park
Kirksville, MO
May 22, 2010
CFAM Summer Meeting
Great Strides CF Walk - Springfield
SUMMER 2010
location to be determined
date to be determined
FALL 2010
Rutledge-Wilson Farm
October 2, 2010
Community Park
Springfield, MO
CFAM Fall Meeting & Fish Fry
Cuba, MO
date to be determined
(probably Oct or Nov)
For more details on scholarship application, please see the scholarships article in the section Sharing Spot.
For more details on meetings and walks, please see the section Upcoming Events.
If you have special events coming up in your area that you would like others of our CF community to know about, in
addition to letting our CF Center Staff know (office 573-882-6978), please consider posting them on the CFAM
Family Support Website (a private and secure website at www.myfamily.com).
What Is the Cystic Fibrosis Association of Missouri?
The Cystic Fibrosis Association of Missouri (CFAM) is a support group for those afflicted with cystic fibrosis, their families
and friends and provides a living community example of the problem of cystic fibrosis at the grass roots level. The purpose of
CFAM (as stated in the by-laws) is to provide information to the general public regarding the disease of cystic fibrosis and related
diseases through the dissemination of pamphlets, and books at no cost to the recipients; to provide, at no cost, forums and support
groups for persons afflicted with cystic fibrosis and related diseases, members of their families and other interested persons; and
to raise funds to support research into the alleviation, cause and cure of cystic fibrosis and related diseases. Any person who
supports the CFAM’s purpose may become a member. There are no membership dues. Meetings are held 3 times a year, in March,
in June or July, and in October or November, at various locations around the State. Everyone is welcome to join us.
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How to Contact Us
CFAM
Ms. Mary McCutcheon, President CFAM, 3428 W. Sexton, Springfield, MO 65810, (417) 894-7637, jolucmar4@gmail.com
Mrs. Mary Backes, Vice President CFAM, 157 Country Rd. 420, Linn, MO 65051, (573) 897-3287, m3backes@gmail.com
Mrs. Sally Hicks, Secretary CFAM, Rt. 1 Box 450, Ava, MO 65608, (417) 683-2195, rhicks@dishmail.net
Mrs. Jennifer Wharton, Treasurer CFAM, 1143 Farm Rd. 48, Pleasant Hope, MO 65725, (417) 839-5034; mojospark@aol.com
Mr. Mike Pratt, Historian CFAM, 3602B West State, Springfield, MO 65802, (417) 862-7553, pratts343@yahoo.com or
danapratt@sbcglobal.net
Mrs. Diane Carney, Chair CFAM Executive Board, 2684 County Rd. 4028, Holts Summit, MO 65043, (573) 896-4737,
ldcarney@embarqmail.com
Cystic Fibrosis on the Trail
To get on the mailing list, or change your mailing address, or to contribute questions, suggestions, stories, photos, poems,
etc. to the newsletter, please call us at, or send correspondence to:
CFAM Newsletter, Department of Child Health, DCO58.00, Univ. of MO, Columbia, MO 65212, (573) 882-6978
Mrs. Diane Carney, 2684 County Road 4028, Holts Summit, MO 65043, (573) 896-4737, ldcarney@embarqmail.com
Mrs. Sally Hicks, Rt. 1 Box 450, Ava, MO 65608, (417) 683-2195, rhicks@dishmail.net
Mrs. Lois Frazier and Mr. Rick Frazier, 1619 Webster, West Plains, MO 65775, (417) 256-5388, special_loe@yahoo.com
Dr. Deborah Chance, Molecular Microbiology & Immunology/Child Health, M616 Medical Sciences Building, Univ. of MO,
Columbia, 65212, (573) 268-8102, chanced@health.missouri.edu
CFAM Family Web Site Lois Frazier, special_loe@yahoo.com
Local CF Contacts
You or your child has CF. Have you ever felt frightened? Alone? Angry? Scared? Helpless . . . maybe even hopeless? Do
you ever feel like no one understands what your family is going through? And for the child with CF, does he ever feel like he is
the only person who has to deal with the problems of CF? It’s tough to deal with a serious illness without a good support system,
and when you deal with a chronic illness, it can really wear you down over time. The good thing about coping with CF here in
Missouri is the wonderful support system available. The CFAM “family” is here to help all of us. Your friends and relatives may
not understand what you are dealing with, but another CF family does!!! Just having someone to talk to who has “been there”
can ease some of the stress when CF gets you down.
Check out the numbers on the map below . . . close to home or far away, feel free to give any of us a call. North or South,
there are lots of people to talk to . . . and we are just a phone call away.
1. Ruth Elliston
Joplin
2. Marty May Galena
3. Mike, Dana, Rhonda &
Springfield Megan Pratt
4. Rick & Lois Frazier West Plains 5. Debbie Douglas Sedalia 6. Laura Frasher Jefferson City Mark & Jeannine Toomey Jefferson City 7. Gary & Mary Backes Linn 8. Larry & Diane Carney Holts Summit 9. John and Julie Klein Columbia 10. Jim & Sandy Conner Kirksville 11. Sophie Backes
St. Louis
12. Bernie & Karen Almeter
Anderson
417-649-7567
417-357-6797
417-862-7553
417-256-5388
660-826-8674
573-636-9934 (h)
573-353-5865 (c)
573-893-4851
573-897-3287
573-896-4737
573-446-9650
660-665-6603
573-690-2446(c)
417-845-6855
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CF Center
Department of Child Health
N601, School of Medicine
One Hospital Dr.
Columbia, MO 65212
RETURN SERVICE REQUESTED
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